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Dragon fruit stem disease significantly affects both the quality and yield of dragon fruit. Therefore, there is an urgent need for an efficient, high-precision intelligent detection method to address the challenge of disease detection. To address the limitations of traditional methods, including slow detection and weak micro-integration capability, this paper proposes an improved YOLOv8-G algorithm. The algorithm reduces computational redundancy by introducing the C2f-Faster module. The loss function was modified to the structured intersection over union (SIoU), and the coordinate attention (CA) and content-aware reorganization feature extraction (CARAFE) modules were incorporated. These enhancements increased the model's stability and improved its accuracy in recognizing small targets. Experimental results showed that the YOLOv8-G algorithm achieved a mean average precision (mAP) of 83.1% and mAP50:95 of 48.3%, representing improvements of 3.3% and 2.3%, respectively, compared to the original model. The model size and floating point operations per second (FLOPS) were reduced to 4.9 MB and 6.9 G, respectively, indicating reductions of 20% and 14.8%. The improved model achieves higher accuracy in disease detection while maintaining a lighter weight, serving as a valuable reference for researchers in the field of dragon fruit stem disease detection.

Thyroid hormones are metabolic indicators to evaluate the physical condition of emergency hospitalized patients, while the relationship between total triiodothyronine and the severity of emergency inpatients is still unclear. To explore the thyroid function levels of inpatients in emergency ward and the status of combined Nonthyroidal illness syndrome (NTIS), and to emphasize the importance of thyroid hormone examination for non-endocrinology inpatients. According to thyroid function of inpatients in emergency ward, they were divided into NTIS group and non-NTIS group, the hematological characteristics and TH levels of each group were analyzed. Based on clinical diagnoses, the hospitalized patients were divided into three major groups, namely infection group, non-infection group and impaired organ function group. Among them, infection group was further divided into sepsis group, lung infection group and local infection group, altogether five groups. The thyroid function levels and low values in each group were evaluated, and the correlation between hormone levels and inflammatory factors, nutritional indicators and the relationship with the risk of death was discussed. The inpatient rate in emergency ward complicated with NTIS was 62.29%, T3 was the most sensitive index of NTIS, followed by FT3. Compared to non-NTIS group, the NTIS group had an increased risk of death. The sepsis group and impaired organ function group had the highest rates of complicated NTIS, reaching 83.33% and 78.12% respectively. Spearman's correlation analysis implied T3/T4/FT3 levels were positively correlated with ALb and PLT (except T4), and negatively correlated with CRP, D-Dimer, IL-6 and Fer. The Receiver Operating Curve (ROC) and Area under the curve (AUC) showed T3 levels alone were strongly associated with the risk of death (AUC 0.750; 95% CI 0.673-0.828; P < 0.001). T3 is the most sensitive indicator for emergency patients, followed by FT3. The decrease of T3 level has a good predictive value for mortality risk. Thyroid function should be monitored in critically ill patients., (© 2024. The Author(s).)

YH0618, a medicinal and edible formulation, has demonstrated the potential to alleviate doxorubicin-induced alopecia in animal studies and clinical trials. However, the mechanisms underlying its therapeutic effects remain unexplored. The objective of this study was to ascertain possible therapeutic targets of YH0618 in the treatment of doxorubicin-induced alopecia. The assessment of hair loss was conducted through the measurement of the proportion of the affected area and the examination of skin histology. Isobaric tags for relative and absolute quantification (iTRAQ) in quantitative proteomics was employed to discern proteins that exhibited variable expressions. The major proteins associated with doxorubicin-induced alopecia were identified using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. The interaction network of the differentially expressed proteins was constructed using the STRING database and the Python software. The study analyzed a total of 3894 proteins extracted from the skin tissue of mice. Doxorubicin treatment resulted in the upregulation of 18 distinct proteins, whereas one differential protein was found to be downregulated. The above effects were reinstated after the administration of the YH0618 therapy. The bioinformatic study revealed that the identified proteins exhibited enrichment in many biological processes, including staphylococcus aureus infection, estrogen signaling route, pyruvate metabolism, chemical carcinogenesis, and PPAR signaling pathway. The results of Western blot revealed that the levels of keratin 81 (Krt81), keratin 34 (Krt34), keratin 33a (Krt33a), and Sma and MAD-related protein 3 (Smad3) were upregulated in response to doxorubicin treatment, and were attenuated by the administration of YH0618. These four proteins are likely to correlate with DOX-induced alopecia and serve as promising therapeutic targets for YH0618. This work presents significant insights and empirical evidence for comprehending the process underlying chemotherapy-induced alopecia, paving the way for exploring innovative therapeutic or preventive strategies employing herbal items., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: Microstates of an electroencephalogram (EEG) are canonical voltage topographies that remain quasi-stable for 90 ms, serving as the foundational elements of brain dynamics. Different changes in EEG microstates can be observed in psychiatric disorders like schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD). However, the similarities and disparatenesses in whole-brain dynamics on a subsecond timescale among individuals diagnosed with SCZ, BD, and MDD are unclear., Methods: This study included 1112 participants (380 individuals diagnosed with SCZ, 330 with BD, 212 with MDD, and 190 demographically matched healthy controls [HCs]). We assembled resting-state EEG data and completed a microstate analysis of all participants using a cross-sectional design., Results: Our research indicates that SCZ, BD, and MDD exhibit distinct patterns of transition among the four EEG microstate states (A, B, C, and D). The analysis of transition probabilities showed a higher frequency of switching from microstates A to B and from B to A in each patient group compared to the HC group, and less frequent transitions from microstates A to C and from C to A in the SCZ and MDD groups compared to the HC group. And the probability of the microstate switching from C to D and D to C in the SCZ group significantly increased compared to those in the patient and HC groups., Conclusions: Our findings provide crucial insights into the abnormalities involved in distributing neural assets and enabling proper transitions between different microstates in patients with major psychiatric disorders.

The COVID-19 pandemic has placed enormous stress on health workers, exposing them to high levels of work-family conflict (WFC), which in turn affects their life well-being（LWB). To date, whether WFC is involved in the association between COVID-19 stress and the well-being of life has not been investigated. The purpose of this paper was to explore the connection between COVID-19 stress and LWB in Chinese nurses and to analyse the mediating role of WFC and the moderating effect of work centrality. The link between COVID-19 stress and LWB was examined by performing multiple regression analysis, common method bias analysis, and confirmatory factor analysis on data for 227 nurses.COVID-19 stress exerted a remarkable direct impact on nurses' LWB, and WFC mediated the link between COVID-19 stress and nurses' LWB. Work centrality moderated the link between COVID-19 stress and nurses' WFC. COVID-19 stress decreases nurses' LWB and increases their WFC, which also decreases their LWB. For nurses with higher work centrality, the connection of COVID-19 stress to work-family conflict was stronger. Hospital managers should focus on nurses' work-family balance and pay particular attention to the work-family balance of work-centered nurses to avoid compromising their LWB., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Self-disclosure (SD) is a common psychological intervention that involves expressing the patient's feelings and thoughts. The purpose of this study was to assess the effectiveness of different themes of SD on cancer patients. We searched eight databases including PubMed, Cochrane Library Trials, Web of Science, CINAHL, Medline, EMBASE, CNKI and Wanfang from inception to July 2022. Other sources included clinical data registers. The Cochrane Collaboration's tool was used to assess the risk of bias in the included studies. RevMan Analysis software 5.3 was used for data analysis. The protocol of this meta-analysis has been registered on PROSPERO (CRD42022339661). Twenty-two RCTs studies were included. The pooled results demonstrated that self-regulation self-disclosure (SRD) had significant effects on patients' sleep quality, benefit-finding, anxiety and quality of life (QOL), whereas emotional disclosure (ED) did not. Furthermore, enhanced self-regulation self-disclosure (ESRD) or cancer-related self-disclosure (CD) significantly improved patients' QOL, although health education self-disclosure (HED) and positive self-disclosure (PD) did not. Our study suggests that different themes of SD have varied effects on patients, but it remains unclear which themes to use at what point in time. Future research should investigate what themes of SD are adopted at different points in time and the duration of different periods., (© 2023 International Union of Psychological Science.)

Polymerization degree plays a vital role in material properties. Previous methodologies of molecular weight control generally cannot suppress or alleviate batch-to-batch variations in device performance, especially in polymer solar cells. Herein, we develop an in-situ photoluminescence system in tandem with a set of analysis and processing procedures to track and estimate the polymerization degree of organic photovoltaic materials. To support the development of this protocol, we introduce polymer acceptor PYT constructed by near-infrared Y-series small molecule acceptors via Stille polymerization, and shed light on the correlations between molecular weight, spectral parameters, and device efficiencies that enable the design of the optical setup and confirm its feasibility. The universality is verified in PYT derivatives with stereoregularity and fluoro-substitution as well as benzo[1,2-b:4,5-b']dithiophene-based polymers. Overall, our result provides a tool to tailor suitable conjugated oligomers applied to polymer solar cells and other organic electronics for industrial scalability and desired cost reduction., (© 2024. The Author(s).)

Backgrounds & Aims: The nutritional evaluation of pancreatic cancer (PC) patients lacks a gold standard or scientific consensus, we aimed to summarize and systematically evaluate the prognostic value of nutritional screening and assessment tools used for PC patients., Methods: Relevant studies were retrieved from major databases (PubMed, Embase, Web of Science, Cochrane Library) and searched from January 2010 to December 2023. We performed meta-analyses with STATA 14.0 when three or more studies used the same tool., Results: This analysis included 27 articles involving 6,060 PC patients. According to a meta-analysis of these studies, poor nutritional status evaluated using five nutritional screening tools Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status Score (CONUT), Nutrition Risk Screening (NRS2002) and Glasgow Prognostic Score (GPS) was associated with all-cause mortality in PC patients. But Modified Glasgow Prognostic Score (mGPS) did not. Of all tools analyzed, CONUT had the maximum HR for mortality (HR = 1.978, 95%CI 1.345-2.907, P = 0.001)., Conclusion: All-cause mortality in PC patients was predicted by poor nutritional status. CONUT may be the best nutritional assessment tool for PC patients. The clinical application value of Short Form Mini Nutritional Assessment (MNA-SF), Generated Subjective Global Assessment (SGA) and Patient-generated Subjective Global Assessment (PG-SGA) in PC patients need to be confirmed. In order to improve patients' nutritional status and promote their recovery, nutritional screening tools can be used., Registration: This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (number CRD42022376715)., (© 2024. The Author(s).)

Polygoni Multiflori Radix (PMR) is a medicinal herb commonly used in China and Eastern Asia. Recently, the discovery of hepatotoxicity in PMR has received considerable attention from scientists. Processing is a traditional Chinese medicine technique used for the effective reduction of toxicity. One uncommon technique is the braising method-also known as 'Wen-Fa' in Chinese-which is used to prepare tonics or poisonous medications. Braised PMR (BPMR)-also known as 'Wen-He-Shou-Wu'-is one of the processed products of the braising method. However, the non-volatile components of BPMR have not been identified and examined in detail, and therefore, the hepatotoxic advantage of BPMR remains unknown. In this study, we compared the microscopic characteristics of different samples in powder form using scanning electron microscopy (SEM), investigated the non-volatile components, assessed the effects of different processed PMR products on the liver, and compared the differences between BPMR and PMR Praeparata recorded in the Chinese Pharmacopoeia (2020 edition). We found that the hepatotoxicity of BPMR was dramatically decreased, which may be related to an increase in polysaccharide content and a decrease in toxic substances. The present study provides an important foundation for future investigations of the processing mechanisms of BPMR., (© 2023 John Wiley & Sons, Ltd.)

Inhalable particle is a harmful air pollutant that causes a significant threat to people's health and ecological environments, which should be removed to purify air, but there exists limited removal efficiency due to particle re-entrainment. Here, Operando observation system based on microscopic visualization method is developed to make in situ test of particle migration, deposition and re-entrainment characteristics on a lab-on-a-chip to achieve the investigation in micro-level scale. The deposition evolution of charged particles is recorded in electric field region intuitively, which confirms the fracture of particle chain occurs during the growth process of deposited particles. It captures the instantaneous process that a larger particle with micron size due to the coagulation of submicron particles fractures from main body of the particle chain for the first time. The analysis of migration behavior of a single submicron particle near electrode surface demonstrates the direct influence of drag force on the fracture of particle chain. This work is the first-time visualization of dynamic process and mechanism elucidation of particle re-entrainment at the micron level, and the findings will provide the theory support for the particle re-entrainment mechanism and bring inspires of enhancing capture efficiency of inhalable particle., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

The evolution of organic semiconductors for organic photovoltaics (OPVs) has resulted in unforeseen outcomes. This has provided substitute choices of photoactive layer materials, which effectively convert sunlight into electricity. Recently developed OPV materials have narrowed down the gaps in efficiency, stability, and cost in devices. Records now show power conversion efficiency in single-junction devices closing to 20%. Despite this, there is still a gap between the currently developed OPV materials and those that meet the requirements of practical applications, especially the solution processability issue widely concerned in the field of OPVs. Based on the general rule that structure determines properties, methodologies to enhance the processability of OPV materials are reviewed and explored from the perspective of material design and views on the further development of processable OPV materials are presented. Considering the current dilemma that the existing evaluation indicators cannot reflect the industrial processability of OPV materials, a more complete set of key performance indicators are proposed for their processability considerations. The purpose of this perspective is to raise awareness of the boundary conditions that exist in industrial OPV manufacturing and to provide guidance for academic research that aspires to contribute to technological advancements., (© 2023 Wiley-VCH GmbH.)

Pemigatinib is a selective fibroblast growth factor receptor (FGFR)1-3 inhibitor and has demonstrated acceptable tolerability and clinical activity in advanced solid tumors in Western population. This phase I trial evaluated pharmacokinetics/pharmacodynamics (PK/PD) characteristics, preliminary safety and efficacy of pemigatinib in Chinese patients with advanced, solid tumors. Patients with unresectable advanced or metastatic solid tumors bearing FGF/FGFR1-3 alterations received oral pemigatinib at 13.5 mg once daily (QD) on a 2-weeks-on/1-week-off schedule. The primary endpoint was PK/PD characteristics; secondary endpoints were safety and efficacy. Twelve patients were enrolled (median age: 61 years, 58.3% males). PK data demonstrated pemigatinib (13.5 mg QD) was rapidly absorbed with a geometric mean elimination half-life of 11.3 h. The geometric mean values of maximum serum concentration and area under the plasma concentration-time curve from 0 to 24 h at steady state were 215.1 nmol/L and 2636.9 h·nmol/L, respectively. The mean clearance adjusted by bioavailability at steady state was low (11.8 L/h), and the apparent oral volume of distribution was moderate (170.5 L). The PD marker, serum phosphate level, increased on days 8 and 15 of cycle 1 (mean: 2.25 mg/dL, CV% [percent coefficient of variation]: 31.3%) and decreased to baseline post 1 week off. Three (25.0%) patients experienced grade ≥ 3 treatment-emergent adverse events. Partial response was confirmed in one patient with FGFR1-mutant esophageal carcinoma and one with FGFR2-mutant cholagiocarcinoma. Pemigatinib had similar PK/PD characteristics to Western population and demonstrated an acceptable safety profile and potential anti-cancer benefit in Chinese patients with FGF/FGFR1-3 altered, advanced, solid tumor. (ClinicalTrials.gov: NCT04258527 [prospectively registered February 6, 2020])., (© 2023. The Author(s).)

The application of most hydrogel bio-adhesives is greatly limited due to their high swelling, low underwater adhesion, and single function. Herein, a spatial multi-level physical-chemical and bio-inspired in-situ bonding strategy is proposed, to develop a multifunctional hydrogel bio-glue using polyglutamic acid (PGA), tyramine hydrochloride (TYR), and tannic acid (TA) as precursors and 4-(4,6-dimethoxytriazine-2-yl) -4-methylmorpholine hydrochloride(DMTMM) as condensation agent, which is used for tissue adhesion, hemostasis and repair. By introducing TYR and TA into the PGA chain, it is demonstrated that not only can the strong adhesion of bio-glue to the surface of various fresh tissues and wet materials be realized through the synergistic effect of spatial multi-level physical and chemical bonding, but also this glue can be endowed with the functions of anti-oxidation and hemostasis. The excellent performance of such bio-glue in the repair of the wound, liver, and cartilage is achieved, showing a great potential in clinical application for such bio-glue. This study will open up a brand-new avenue for the development of multifunctional hydrogel biological adhesive., (© 2023 Wiley-VCH GmbH.)

Mucosal healing is essential for treating ulcerative colitis (UC), which results from imbalanced macrophage polarization and dysregulated inflammatory responses. However, the mechanisms of cellular communication and signal transduction that regulate mucosal healing among macrophage subtypes require further investigation. We use bulk and single-cell RNA sequencing analysis to reveal that macrophage subtypes vary in different UC states. At the same time, chemokine and angiogenesis signaling is strongly associated with M2 macrophage's infiltrated proportion. To get more insight into subtypes of macrophages in mucosal healing, we divided macrophages into M1, M2b, and M2d macrophages. Based on the differentially expressed genes (DEGs) between M2d and M1 macrophages, KEGG and GO analysis highlights M2d macrophages' ability to alleviate inflammation and promote epithelial healing. Trajectory analysis revealed opposite differentiation of macrophage subsets between UC and healthy groups, with M1 and M2d macrophages coexisting in the same differentiation branch under UC conditions. Along the pseudotime axis, CCL3 and VEGFA expression increased in UC, while IL10RA remained stable in UC but increased in healthy controls. CellChat identified CCL3-CCR1 has strong communication between M1 and M2d macrophages, while the IL10 signaling pathway is activated explicitly in M2d macrophages to mitigate inflammation and promote epithelial healing. We also speculate that high levels of VEGFA activate endothelial cells expressing VEGFR and worsen inflammation. To conclude, we suggested IL10 and VEGF signaling in M2d macrophages as potential therapeutic targets for mucosal healing. However, it is necessary to establish reliable methods for isolating and purifying M2d macrophages before these targets can be effectively utilized., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Studies have shown that bullying victimization may be related to internalizing and externalizing problems; however, the mechanism underlying this relationship remains unknown. This study explored the mediating role of sleep disturbance and the moderating role of parental attachment., Methods: A total of 1543 Chinese primary school students (M age = 8.92 years, SD1.7 years; range, 6-12) completed bullying victimization, sleep disturbance, and parental attachment measures, and provided information on their parents' occupations. The parents or guardians (n = 1995) also completed ratings on their children's internalizing and externalizing problems., Results: It was found that bullying victimization directly affected internalizing and externalizing problems and also influenced sleep disturbance. Regardless of the parent's socioeconomic status, parental attachment was found to moderate the relationship between bullying victimization and internalizing problems., Conclusions: These findings contribute to understanding the partial mediating mechanism of sleep disturbance in the association between bullying victimization and internalizing and externalizing problems. The protective role of parental attachment proved central to preventing internalizing problems in bullied children. Intervention programs that enhance parental attachment and improve sleep quality could assist in mitigating the impact of bullying victimization on internalizing or externalizing problems., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2023. Published by Elsevier Ltd.)

Aims: The aim of this study was to investigate the effect of intimacy and dyadic coping on anxiety and depression in patients with pancreatic cancer and their spousal caregivers., Methods: This study conducted from October 2021 to June 2022, included 277 pancreatic cancer patients and their spousal caregivers. This research used actor-partner interdependence mediation model to explore the relationship of intimacy, dyadic coping, and psychological distress among pancreatic cancer patients and their spousal caregivers., Results: The results of this study showed that there were two actor effects: the satisfaction of intimate relationship between pancreatic cancer patients and their spouse caregivers had a positive predictive effect on their dyadic coping ( β  = 1.787, p  < 0.001) and ( β  = 1.587, p  < 0.001). The dyadic coping of pancreatic cancer patients and their spouse caregivers had a negative predictive effect on their own anxiety and depression ( β  = -0.253, p  < 0.001) and ( β  = -0.293, p  < 0.001). The results of this study showed that there was a partner effect: intimate relationship satisfaction of pancreatic cancer patients had a positive predictive effect on dyadic coping of their spousal caregivers ( β  = 0.574, p  < 0.05)., Conclusion: This study demonstrates the interdependence of pancreatic cancer patients and their spousal caregivers in coping with the disease. The healthy intimate relationship and effective dyadic coping styles are essential to alleviating disease pressure and lowering the psychological burden on cancer families., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Li, Liu, Chen, Su, Yao and Li.)

Achieving a finely tuned active layer morphology with a suitable vertical phase to facilitate both charge generation and charge transport has long been the main goal for pursuing the highly efficient bulk heterojunction all-polymer solar cells (all-PSCs). Herein, a solution to address the above challenge via synergistically combining the ternary blend strategy and the layer-by-layer (LbL) procedure is proposed. By introducing a synthesized polymer acceptor (P A ), PY-Cl, with higher crystallinity into the designed host acceptor PY-SSe-V, vertical phase distribution and molecular ordering of the LbL-type ternary all-PSCs can be improved in comparison to the LbL-type PM6/PY-SSe-V binary all-PSCs. The formation of the superior bulk microstructure can not only promote charge transport and extraction properties but also reduce energetic disorder and non-radiative recombination loss, thus improving all three photovoltaic parameters simultaneously. Consequently, the PM6/(PY-SSe-V:PY-Cl) ternary all-PSCs show the best efficiency of 18.14%, which is among the highest values reported to date for all-PSCs. This work provides a facile and effective LbL-type ternary strategy for obtaining high-efficiency all-PSCs., (© 2022 Wiley-VCH GmbH.)

Objective: The purpose of this study was to describe symptom clusters (SCs), and symptom experiences in early postoperative patients with pancreatic cancer who are recovering at home., Methods: From October 2021 and April 2022,15 patients following pancreatic cancer surgery were recruited from a tertiary hospital in Jiangsu Province by maximum variation sampling. Semi-structured interviews were performed to collect data and thematic analysis was conducted to analyze the data., Results: Three themes were extracted from the data. The first theme "difference in symptom perception and cognition" illustrated factors such as patient knowledge, expected recovery status, and risk perception could influence patient symptom experience. Most patients actually reported fewer and less severe symptoms than previous studies. The second theme "the results of symptom cluster" demonstrated anorexia-distress SC, bowel-digestive related SC and sleep disturbance related SC, and anorexia-distress SC should be considered as the priority SC given its multidimensional significance for patients. The last theme described the patient's positive attitudes, behaviours and barriers to coping with symptoms, namely "symptom self-management experience"., Conclusion: There are differences in the perception and interpretation of SCs in postoperative pancreatic cancer patients. Understanding the meaning of individual differences in the experience of symptoms can assist patients in the management of SCs. Medical staff should combine patient self-management strategies and evidence-based data to provide appropriate support at different stages to improve patient symptom management and quality of life., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To assess the safety and efficacy of antimicrobial peptide PL-5 (Peceleganan) spray in the treatment of wound infections., Background: Antimicrobial peptide PL-5 spray is a novel topical antimicrobial agent., Methods: We conducted a multicenter, open-label, randomized, controlled phase IIb clinical trial to evaluate the efficacy and safety of PL-5 spray, as compared with silver sulfadiazine, in patients with skin wound infections. The primary efficacy outcome was the clinical efficacy rate on the first day after ending the treatment (D8). The secondary efficacy outcome was the clinical efficacy rate on the fifth day posttreatment (D5), the bacteria clearance rate, and the overall efficacy rate at the mentioned 2 time points. The safety outcomes included adverse reactions and pharmacokinetic analysis posttreatment., Results: A total of 220 patients from 27 hospitals in China were randomly assigned to 4 groups. On D8, the efficacy rate was 100.0%, 96.7%, 96.7% for the 1‰ PL-5, 2‰ PL-5, 4‰ PL-5 groups, respectively, as compared with 87.5% for the control group. The efficacy rate among the 4 groups was significantly different ( P <0.05). On D5, the efficacy rate was 100.0%, 93.4%, 98.3% for the 1‰ PL-5, 2‰ PL-5, 4‰ PL-5 groups, respectively, as compared with 82.5% for the control group. The efficacy rate among the 4 groups was significantly different ( P <0.05). The blood concentration of PL-5 was not detectable in pharmacokinetic analysis. No severe adverse event related to the application of PL-5 was reported., Conclusions: Antimicrobial peptide PL-5 spray is safe and effective for the treatment of skin wound infections., Trial Registration: ChiCTR2000033334., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Due to the avascular nature of cartilage, it is difficult to heal and regenerate spontaneously after injury. At present, tissue engineering has become a promising strategy for repairing damaged cartilage, but the use of seed cells and growth factors is limited. In addition, the importance of mechanical compatibility of scaffold materials is often ignored. In this study, osteochondral scaffold was designed as a bilayer structure with a dense γ-Polyglutamic acid/carboxymethyl chitosan/bacterial cellulose (PGA/CMCS/BC) hydrogel cartilage layer and a porous nano HA-containing PGA/CMCS/BC hydrogel osteogenic layer. In addition, bioactive ions were introduced into the hydrogel scaffold to adjust the mechanical and swelling properties of the material to match the mechanical properties of natural articular cartilage. At the same time, based on the structural characteristics of bone and cartilage, magnesium and copper ions were introduced into the double-layer hydrogel scaffold, respectively, to prepare the cartilage layer and the bone layer, which endowed the material with excellent antibacterial properties and achieved the purpose of the integrated repair of bone and cartilage. The results showed that, after adding magnesium ions, the tensile breaking strength of material was increased from 0.66 MPa to 1.37 MPa，the corresponding compression modulus of the material (strain 0-12%) increased from 0.15 MPa to 0.58 MPa whilst the maximum mass swelling rate decreased from 155% to 75%. The results of in vivo experiments show that the group with bioactive ions had a much better effect on the repair of osteochondral defects, compared with group without bioactive ions, demonstrating such double ion regulation strategy is a very practical strategy for the treatment of osteochondral defects., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Naoqingzhiming, whose active ingredient is echinacoside, is the first new Class I natural medicine approved for clinical trials for the therapeutic potential of vascular dementia in China. We report randomized, double-blind, placebo-controlled trials to evaluate the safety, tolerability and pharmacokinetics of single ascending doses of Naoqingzhiming tablet after oral administration in healthy Chinese subjects. The single ascending dose of Naoqingzhiming tablet (180-2160 mg) were well tolerated in all enrolled subjects, without serious adverse events and adverse events leading to withdrawal from the study. The most common drug-related treatment-emergent adverse events were elevated blood bilirubin and serum uric acid. No clinically significant findings were found in the physical examinations, vital signs or electrocardiograms. After single-dose administration of Naoqingzhiming tablet, echinacoside was absorbed with a T max at 1.25-1.75 h and declined with a t 1/2 of 2.42-3.33 h. However, the proportionality coefficients for C max , AUC 0-t and AUC 0-∞ of echinacoside were not fully contained in the pre-defined 90 % CI criterion (0.91-1.09). As a result, the dose proportionality could not be concluded statistically within the dosage range of this study. Overall, the safety profile and PK properties support further development and use of Naoqingzhiming in vascular dementia., Competing Interests: Conflicts of Interest Statement Mingxia Chen, Haiyan Jiang, Fanli Yan and Yahui Han are employees of Beijing Scrianen Pharmaceutical Co., Ltd. Other authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

The lack of vascular tissue and the low metabolism and biological activity of mature chondrocytes lead to the low regeneration ability of articular cartilage. People try to solve this problem through various methods, but the effect is not very ideal. Inspired by the piezoelectric effect of collagen in cartilage tissue, this work focused on the design of a biomimetic hydrogel by introducing piezoelectric materials and silver nanowires into hydrogel to endow them with piezoelectric and antibacterial properties to promote tissue regeneration. Additionally, the mechanical and swelling properties of the material were adjusted to match natural articular cartilage. Based on bionic principles, a double-layer piezoelectric hydrogel was prepared and applied for the repair of osteochondral defects. An enhanced repair effect of osteochondral defects has been seen, which has demonstrated potential values for future application in bionics principle- and piezoelectric effect-based osteochondral tissue engineering. Furthermore, piezoelectric effect-induced degradation was observed. These results fully indicated the positive effect of the piezoelectric effect on promoting the regeneration of osteochondral tissue and in vivo degradation of materials.

The high-voltage electric field can effectively capture charged aerosols and has the effect of killing microbial aerosols simultaneously. In this article, an innovative visualization method for investigating the dynamic characteristic of submicron-scale aerosol particles in the high-voltage electric field is developed. Based on reasonable working principles and reliable experimental schemes, the movement of submicron-scale aerosol particles is observed and visualization images in different working conditions are photographed. Besides, with the aid of numerical method and solution of related equations, simulation researches on flow field distribution, electrostatic field characteristics, particle charging and motion behavior characteristics are also carried out. Visualization results prove the linear motion law of aerosol particles in an electric field of 0-3 kV/cm unit. As for 1 µm diameter particle, its migration velocity in 1 kV/cm electric field is measured as 0.016 m/s and 0.019 m/s after positive and negative charging of 1.5 kV voltage, respectively. A reliable calculation formula (η=(V j q p L j )/(3πμD 2 u x d p )) for predicting collection efficiency is derived and established based on actual particle migration velocity. The researches on the migration and capture law of submicron-scale aerosol in the high voltage electric field gives a key reference for the development and design of efficient removal of microbial aerosol and air purification equipment., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: China has a high burden of hepatocellular carcinoma, and hepatitis B virus (HBV) infection is the main causative factor. Patients with hepatocellular carcinoma have a poor prognosis and a substantial unmet clinical need. The phase 2-3 ORIENT-32 study aimed to assess sintilimab (a PD-1 inhibitor) plus IBI305, a bevacizumab biosimilar, versus sorafenib as a first-line treatment for unresectable HBV-associated hepatocellular carcinoma., Methods: This randomised, open-label, phase 2-3 study was done at 50 clinical sites in China. Patients aged 18 years or older with histologically or cytologically diagnosed or clinically confirmed unresectable or metastatic hepatocellular carcinoma, no previous systemic treatment, and a baseline Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 were eligible for inclusion. In the phase 2 part of the study, patients received intravenous sintilimab (200 mg every 3 weeks) plus intravenous IBI305 (15 mg/kg every 3 weeks). In the phase 3 part, patients were randomly assigned (2:1) to receive either sintilimab plus IBI305 (sintilimab-bevacizumab biosimilar group) or sorafenib (400 mg orally twice daily; sorafenib group), until disease progression or unacceptable toxicity. Randomisation was done using permuted block randomisation, with a block size of six, via an interactive web response system, and stratified by macrovascular invasion or extrahepatic metastasis, baseline α-fetoprotein, and ECOG performance status. The primary endpoint of the phase 2 part of the study was safety, assessed in all patients who received at least one dose of study drug. The co-primary endpoints of the phase 3 part of the study were overall survival and independent radiological review committee (IRRC)-assessed progression-free survival according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 in the intention-to-treat population. The study is registered with ClinicalTrials.gov, NCT03794440. The study is closed to new participants and follow-up is ongoing for long-term outcomes., Findings: Between Feb 11, 2019 and Jan 15, 2020, we enrolled 595 patients: 24 were enrolled directly into the phase 2 safety run-in and 571 were randomly assigned to sintilimab-bevacizumab biosimilar (n=380) or sorafenib (n=191). In the phase 2 part of the trial, 24 patients received at least one dose of the study drug, with an objective response rate of 25·0% (95% CI 9·8-46·7). Based on the preliminary safety and activity data of the phase 2 part, in which grade 3 or worse treatment-related adverse events occurred in seven (29%) of 24 patients, the randomised phase 3 part was started. At data cutoff (Aug 15, 2020), the median follow-up was 10·0 months (IQR 8·5-11·7) in the sintilimab-bevacizumab biosimilar group and 10·0 months (8·4-11·7) in the sorafenib group. Patients in the sintilimab-bevacizumab biosimilar group had a significantly longer IRRC-assessed median progression-free survival (4·6 months [95% CI 4·1-5·7]) than did patients in the sorafenib group (2·8 months [2·7-3·2]; stratified hazard ratio [HR] 0·56, 95% CI 0·46-0·70; p<0·0001). In the first interim analysis of overall survival, sintilimab-bevacizumab biosimilar showed a significantly longer overall survival than did sorafenib (median not reached [95% CI not reached-not reached] vs 10·4 months [8·5-not reached]; HR 0·57, 95% CI 0·43-0·75; p<0·0001). The most common grade 3-4 treatment-emergent adverse events were hypertension (55 [14%] of 380 patients in the sintilimab-bevacizumab biosimilar group vs 11 [6%] of 185 patients in the sorafenib group) and palmar-plantar erythrodysaesthesia syndrome (none vs 22 [12%]). 123 (32%) patients in the sintilimab-bevacizumab biosimilar group and 36 (19%) patients in the sorafenib group had serious adverse events. Treatment-related adverse events that led to death occurred in six (2%) patients in the sintilimab-bevacizumab biosimilar group (one patient with abnormal liver function, one patient with both hepatic failure and gastrointestinal haemorrhage, one patient with interstitial lung disease, one patient with both hepatic faliure and hyperkalemia, one patient with upper gastrointestinal haemorrhage, and one patient with intestinal volvulus) and two (1%) patients in the sorafenib group (one patient with gastrointestinal haemorrhage and one patient with death of unknown cause)., Interpretation: Sintilimab plus IBI305 showed a significant overall survival and progression-free survival benefit versus sorafenib in the first-line setting for Chinese patients with unresectable, HBV-associated hepatocellular carcinoma, with an acceptable safety profile. This combination regimen could provide a novel treatment option for such patients., Funding: Innovent Biologics., Translation: For the Chinese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests ZR has received honoraria as an advisor from Innovent Biologics, AstraZeneca, F Hoffmann-La Roche, and Merck Sharp & Dohme. YY, MC, YW. and HZ are employees of Innovent Biologics. All other authors declare no competing interests., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Various manganese oxides (MnO x ) prepared via citric acid solution combustion synthesis were applied for catalytic oxidation of benzene. The results showed the ratios of citric acid/manganese nitrate in synthesizing process positively affected the physicochemical properties of MnO x , e.g., BET (Brunauer-Emmett-Teller) surface area, porous structure, reducibility and so on, which were in close relationship with their catalytic performance. Of all the catalysts, the sample prepared at a citric acid/manganese nitrate ratio of 2:1 (C2M1) displayed the best catalytic activity with T 90 (the temperature when 90% of benzene was catalytically oxidized) of 212℃. Further investigation showed that C2M1 was Mn 2 O 3 with abundant nano-pores, the largest surface area and the proper ratio of surface Mn 4+ /Mn 3+ , resulting in preferable low-temperature reducibility and abundant surface active adsorbed oxygen species. The analysis results of the in-situ Fourier transform infrared spectroscopy (in-situ FTIR) revealed that the benzene was successively oxidized to phenolate, o-benzoquinone, small molecules (such as maleates, acetates, and vinyl), and finally transformed to CO 2 and H 2 O., Competing Interests: Declaration of competing interest We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted., (Copyright © 2020. Published by Elsevier B.V.)

The epithelial-mesenchymal transition (EMT) process is a key priming activity of fibroblasts in pulmonary fibrosis during silicosis. Ets-like protein-1 (Elk-1) is a critical modulator that promotes functional changes in cells, and the effects are mediated by oxidative stress (OS). However, whether ELK-1 is involved in EMT of silicosis remains unclear. In addition, researchers have found that Elk-1 is involved in the expression of the gene zc3h12a, which encodes the protein MCPIP1, and MCPIP1 is a member of the zinc finger Cys-Cys-Cys-His (CCCH)-type protein family. A previous study from our lab showed that ZC3H4, which is also a member of the CCCH-type protein family, critically affected the regulation of EMT during silicosis. However, it has not yet been elucidated if ELK-1 acts at the promoter for zc3h4 to increase its expression in a mechanism that is similar to that of the zc3h12a gene and whether such regulation ultimately controls EMT. Therefore, we explored the correlation between ELK-1 and ZC3H4 expression and tested the underlying mechanisms affecting ELK-1 activation induced by silica. Our study identifies that SiO 2 -mediated EMT via ELK-1, with the upstream activity of OS and the downstream signaling of ZC3H4 expression resulting in enhanced EMT. These findings suggest that the nuclear transcription factor ELK-1 may be useful as a novel target for the treatment of pulmonary fibrosis.

Background: Following acute ischemic stroke (AIS), approximately half of patients do not achieve recanalization after intravenous administration of tissue plasminogen activator (rt-PA). Thrombolysis resistance is a possible reason for recanalization failure. Thrombolysis resistance is likely related to the ultrastructure and composition of the thrombus. However, there is a paucity of published information on the relationship between thrombus ultrastructure and thrombolysis resistance., Case Presentation: Two patients who underwent mechanical thrombectomy were observed within 4.5 h after stroke onset. One patient failed to respond to rt-PA (defined as thrombolysis resistant), and the other patient did not receive rt-PA treatment (non-rtPA). In each patient, the occluded artery was the internal carotid artery or middle cerebral artery. According to the Trial of ORG 10172 in Acute Stroke Treatment classification, both patients had large atherosclerotic cerebral infarction. By scanning electron microscopy (SEM) and transmission electron microscopy (TEM), we found that the thrombus structure was significantly different between the two patients., Conclusion: Grid-like dense fibrin, compressed polyhedral erythrocytes, and large accumulation of neutrophils may be characteristics of thrombolysis resistant thrombi.

Background and Purpose: To reduce the resistance and allergic reaction to chlorhexidine acetate (CHA) in the current treatment of (Bacterial vaginosis) BV and (vulvovaginal candidiasis) VVC in female vaginitis. In this study, the antimicrobial activities and mechanism of action of the synergistic effects of antimicrobial peptides (AMPs) HPRP-A1 and HPRP-A2, and CHA, against Gram-negative and Gram-positive bacteria, and one fungus Candida albicans ( C. albicans ) were investigated in vitro and in mouse and rat vaginitis infection models in vivo., Results: HPRP-A1, HPRP-A2 and CHA showed significant synergistic effects on the antimicrobial activities against different Gram-negative and Gram-positive bacteria and C. albicans . The combined application of HPRP-A2 and CHA exhibited strong synergistic effects in the mouse and rat vaginitis models caused by bacteria or C. albicans ., Conclusion: This study may prompt the development of new drug combinations against vaginitis infections, including mixed bacterial and fungal infections and multi-drug-resistant infections., Competing Interests: Mingxia Chen is an employee and Yuxin Chen is one of the shareholders of Jiangsu ProteLight Pharmaceutical & Biotechnology Co., Ltd. The authors report no other conflicts of interest in this work., (© 2019 Zhu et al.)

The voltage-gated potassium (Kv) channel blockers tetraethylammonium (TEA) and 4-aminopyridine (4-AP) have shown beneficial effects on some neurological disorders. But their involvements in diabetes-associated cognitive dysfunction are still unknown. The present study aims to investigate whether the blockade of Kv channels by TEA and 4-AP alleviate cognitive decline in diabetes. In vivo, the effects of TEA and 4-AP (5 mg/kg body weight per day, 1 mg/kg body weight per day intraperitoneal injected for 4 weeks, respectively) were investigated in streptozotocin-induced C57BL/6 diabetic mice. In vitro study, we investigated the effects of TEA and 4-AP on the high glucose (HG) -stimulated primary cortical neurons. The results showed that TEA and 4-AP ameliorated the cognitive decline of diabetic mice in the Morris water maze test, improved the ultrastructure of pancreatic β cells, hippocampal neurons and synapses, decreased oxidative stress, modulated apoptosis-related proteins, and activated phosphatidylinositol 3-kinase (PI3K)/ Protein kinase-B (PKB or Akt) signaling pathway. In the HG-stimulated primary cultured cortical neurons, TEA and 4-AP increased the cell viability, decreased oxidative stress; prevented apoptosis and activated PI3K/Akt signaling pathway. Additionally, the PI3K inhibitor LY294002 partially abolished the effects of TEA and 4-AP. These findings indicate that the blockade of Kv channels by TEA and 4-AP ameliorates the diabetes-associated cognitive dysfunction via PI3K/Akt pathway, suggesting that targeting Kv channels could be a promising strategy for the treatments of cognitive impairments in diabetes., (Copyright © 2019. Published by Elsevier Inc.)

Objective: The objective of this study was to examine the clinical and magnetic resonance imaging (MRI) outcomes of extensive tenosynovectomy on patients with diffuse flexor hallucis longus tenosynovitis combined with effusion (DFHLT-E)., Methods: Consecutive patients undergoing extensive tenosynovectomy for DFHLT-E in the same foot and ankle center from January 2013 to December 2016 were selected; a total of 14 patients were included in the final analysis. Patients with a minimum 1-year follow-up were evaluated with physical examination, MRI, American Orthopaedic Foot and Ankle Society (AOFAS) clinical midfoot scale, and visual analog scale (VAS) pain scores., Results: The 14 patients were followed up for an average of 15.0 ± 2.3 months (12-18 months). There were no recurrences in all clinical examinations at the final follow-up. The AOFAS score was improved from 61.57 ± 10.70 before surgery to 90.28 ± 9.41 at the final follow-up. The difference was statistically significant ( p = 0.001). The VAS score was improved from 4.00 ± 0.82 before surgery to 0.43 ± 0.53 at the final follow-up ( p < 0.001). MRI examination revealed two patients with small residual and limited effusion with no clinical symptoms. Superficial pin infection was observed in one patient, and two patients had transient neurostimulation., Conclusions: Extensive tenosynovectomy is an effective alternative for the treatment of DFHLT-E with less complications or recurrence.

Objective: We analysed lncRNA expression profiles in atrial samples from patients with rheumatic mitral valve disease (RMVD) to identify the potential differences in atrial fibrillation (AF)-associated lncRNAs between RMVD patients with AF and sinus rhythm (SR)., Methods: Masson's trichrome staining and scanning electron microscopy were performed to evaluate the tissue morphology. Western blotting was performed to detect the expression of fibrosis-related proteins. Difference analysis, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene co-expression networks were also adopted to perform IncRNA expression profile analysis in atrial samples., Results: Masson's trichrome staining indicated higher contents of fat deposition and fibrous tissue in atrial samples from patients with AF than from patients with SR. Western blotting showed that fibrosis-related proteins, including smad2, TGFβ1, MMP9, and TIMP1, were upregulated in atrial samples from patients with AF compared to those from patients with SR. lncRNA expression profiles showed different lncRNA expression levels between RMVD patients with AF and SR. Moreover, GO, KEGG and gene co-expression networks showed consistent results and indicated that differentially expressed genes might contribute to the pathogenesis of AF., Conclusion: Our results revealed the potential roles of IncRNAs in the development of AF in patients with RMVD, and lncRNAs may be responsible for morphological and physiological differences in atria between RMVD patients with AF and SR., (© 2019 Wiley Periodicals, Inc.)

Purpose: To screen novel candidate biomarkers in primary colorectal cancer (CRC), and indentify their clinical valuation in progress of colorectal cancer., Methods: By using antibody microarray, 274 target proteins in tissue samples from primary colorectal cancer patients were detected. Among differently expressed proteins in CRC tissues, As promising candidate biomarker, RANTES/CCL5 was validated by enzyme-linked immunosorbentassay and immunohistochemistry (IHC), and the clinical significance of CCL5 was analyzed., Results: Totally, 25 differentially expressed proteins were indentified between colorectal cancers and matched normal mucosa. CCL5 expression was significantly associated with adverse pathological progress, apt to lymph node metastasis and higher T stage., Conclusions: CCL5 may contribute to promoting tumor growth, and CCL5 is a promising target that may help in understanding the pathogenesis of CRC., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

Objective: To investigate the effects and mechanism of salidroside(SAL) on model rats of diabetic nephropathy(DN)., Methods: Rats were divided into control, model, SAL(50 mg/kg), SAL(100 mg/kg) and SAL(200 mg/kg) groups. The rats beside in control group were injected with streptozotocin(STZ) combined with right nephrectomy. And rats in SAL(50, 100, 200 mg/kg) groups were received gavage with SAL(50, 100, 200 mg/kg). After 12 weeks, rats were sacrificed and kidneys were collected. HE staining was performed for renal injury, the concentrations of urine protein, urine creatine(Ucr), blood urea nitrogen(BUN), malondialdehyde(MDA), superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) were measured by kits. Western blot was used to measure the protein levels of Collagen Ⅳ, fibronectin, E-cadherin, α-smooth muscle actin(α-SMA), N-cadherin, Smad2、Smad3, phosphorylated-Smad2(p-Smad2), p-Smad3 and transforming growth factor-β1(TGF-β1)., Results: Compared with control group, the renal injury of rats in model group was aggravated, the concentrations of urine protein, Ucr and BUN were elevated significantly, the apoptosis cells and positive cells of caspase-3 were increased; compared with model group, the renal injury of rats in SAL(100, 200 mg/kg) groups were alleviated markedly, the concentrations of urine protein, Ucr and BUN were reduced, the apoptosis cells and positive cells of caspase-3 were decreased notably. SAL(50 mg/kg) increased the concentration of SOD in DN model rats, SAL(100, 200 mg/kg) increased the concentrations of SOD and GSH-Px, decreased the level of MDA. Meanwhile, the inhibition of collagen Ⅳ, fibronrctin, α-SMA, and N-cadherin and the induction of E-cadherin in DN rats were induced by SAL(100, 200 mg/kg). In addition, SAL(100, 200 mg/kg) reduced the ratio of p-Smad2/Smad2, p-Smad3/Smad3 and the level of TGF-β1(P<0.05 or P<0.01)., Conclusion: SAL can inhibit renal fibrosis of STZ-induced DN model rats, and the mechanism may be related to inhibition of TGF-β1/Smad pathway.

Cooking oil fumes as an important source of volatile organic compounds in metropolitan areas are poisonous to the environment and human health. In this study, the removal of hexanal (a representative of cooking fume) using "storage-plasma catalytic oxidation" at ambient conditions has been investigated. Alkali-modified Co-Mn catalysts were synthesized by coprecipitation method and further characterized by XRD, SEM, N 2 adsorption-desorption, H 2 -TPR, O 2 -TPD and XPS techniques. It was clearly shown that the Na modification afforded a remarkable enhancement in the hexanal storage capacity, which is ascribed to the formation of surface hydroxyls that resulted in the chemical adsorption. Moreover, the plasma-catalytic oxidation results showed 99.4% hexanal removal and 85.7% CO 2 selectivity at a GHSV of 47700 h -1 . XPS results revealed that Na modification promoted the formation of more abundant Co 3+ , Mn 3+ cations and surface adsorbed oxygen species, thus facilitated the oxidation process. In-situ FTIR results revealed that Na modification could trigger disproportionation reaction, resulting in the transformation of adsorbed hexanal into alcohol and carboxylic acid thus further speeds up the oxidation rate. This work provides a low-cost, highly efficient and energy-consuming approach for the removal of gaseous cooking fume by storage and plasma catalytic oxidation cycle at room temperature., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Different levels of telemedicine systems have been built across China. To share high-quality medical resources and conduct centralized management of telemedicine systems, a regional telemedicine system (RTS) (such as a provincial level system) has been developed to integrate with small-scale telemedicine systems. Although the established systems offer integration services, they are tightly coupled systems, and not easily integrated with new systems. Meanwhile, with the increasing of input/output, it is difficult for them to run with high scalability, considering the cost of architecture redesign and further development. This article presents the design and implementation of regional integration system through a study in Henan, China, mainly aimed to integrate with heterogeneous small-scale telemedicine systems and provide high efficiency., Methods: A provincial telemedicine system and some city-level telemedicine systems have already been established. The provincial system has been built to act as a regional integration system to connect city-level systems. Adopting message-based technology, the provincial system achieves high availability and high scalability, respectively, through LevelDB + ZooKeeper and multicast., Results: The system achieved the centralized management of established telemedicine systems without restructuring their framework, improving high availability of RTS when one ActiveMQ service node in a group failed, and it did not negatively influence normal business logic when adding a new service node. At the same time, two "Master" state ActiveMQ service nodes provided services simultaneously, which enable the RTS to achieve high scalability., Conclusions: The message-based regional integration system enriched the RTS with high availability, easy extensibility, and provided a convenient way to integrate new small-scale telemedicine systems.

Our daily exposure to ultraviolet radiation (UVR) results in the production of reactive oxygen species (ROS), lipids, proteins and DNA damage and alteration in fibroblast structure, thus contributing to skin photoaging. For this reason, the use of natural bioactive compounds with antioxidant activity could be a strategic tool to overcome ultraviolet A (UV-A) induced deleterious effect. Neferine is an alkaloid extract from the seed embryos of lotus ( Nelumbo nucifera Gaertn). In the present study, we report the protective effect of neferine against UV-A induced oxidative stress and photoaging in human dermal fibroblasts (HDFs). HDFs subjected to UV-A irradiation showed increased production of ROS and malondialdehyde (MDA). Furthermore, it depleted the cellular enzymatic antioxidant superoxide dismutase (SOD) and non-enzymatic antioxidant glutathione peroxidase (GPx). On the other hand, HDFs treated with neferine followed by UV-A irradiation reversed the process, reduced the ROS and lipid peroxidation and restored the antioxidants pool. Moreover, neferine treatment significantly inhibited UV-A induced matrix metalloproteinase-1 (MMP-1) expression in HDFs. Remarkable morphological and ultrastructural alterations observed in HDFs upon UV-A irradiation, were also reduced with neferine treatment. Taken together, our results suggest that neferine has strong antioxidative and photoprotective properties and thus may be a potential agent for the prevention and treatment of UV-A mediated skin photoaging., (© 2018 The Author(s).)

Background: Studies have shown that skin exposure to ultraviolet radiation (UVR) results in the formation of reactive oxygen species (ROS), thus altering the cellular function. The human epidermal skin layer is mainly composed of keratinocytes, which is damaged by UV-B radiation-induced intracellular oxidative stress. Neferine is an alkaloid extract from lotus seed embryos and is known to promote antioxidant activity., Objective: In this study for the first time, we investigated the photoprotective action of neferine, against UV-B-produced oxidative damage in human epidermal keratinocytes (HEKs)., Methods: We established an in Vitro study model using HEKs. Cellular viability was determined by MMT assay kits. The intracellular oxidative stress was measured using ROS and malondialdehyde (MDA) assay kits. Endogenous antioxidants were measured by superoxide dismutase (SOD) and glutathione peroxidase (GPx) assay kits. Photoprotective nature of neferine was further evaluated by analyzing the morphological and ultrastructural alterations in keratinocytes., Results: Neferine inhibit the UV-B-mediated increase in ROS and MDA levels in pretreated keratinocytes. The antioxidants, SOD and GPx activities were significantly high in neferine pretreated UV-B groups. Mitochondrial and endoplasmic reticulum damage were less evident in neferine-pretreated UV-B groups as compared with the control group, which might be associated with reduced oxidative stress and lipid peroxidation., Conclusion: Taken together, our results suggest that neferine can prevent UV-B-induced oxidative damage and may thus be a potential agent for prevention and treatment of skin damage and photoaging.

Aims: This study aimed to determine the influence of Tang Wang Ming Mu granule (TWMM) on the diabetic retinopathy of diabetic rats. Methods: Male Wistar rats were divided into seven groups: normal control, diabetes model(DM), diabetes with TWMM (3.6, 7.2, and 14.4 g/kg) treatment, the positive control treatment groups of Qi Ming granules and Calcium dobesilate capsules. All rats were treated for 8 weeks. The levels of body weight, fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) in blood were measured to evaluate the antihyperglycemic activity of TWMM. Furthermore, malondialdehyde (MDA), intracellular adhesion molecule-1 (ICAM-1) and vascular endothelial growth factor (VEGF) in serum were measured to study effects of TWMM on oxidative stress and inflammatory in DM2 rats. VEGF, JAK/STAT signaling pathway and SOCS3 in retina was detected by immunohistochemistry. Results: TWMM and the positive control drugs Qi Ming and Calcium dobesilate showed a remarkable suppression of retinal neovascularization and amelioration of retinal internal limiting membrane morphology. Moreover, TWMM significantly decreased HbA1c, MDA, ICAM-1, and VEGF levels in serum of diabetic rats. However, Qi Ming granules showed significantly reduced MDA and VEGF levels ( P < 0.01, and P < 0.05, respectively), Calcium dobesilate showed significantly reduced MDA and ICAM-1levels ( P < 0.01 and P < 0.05, respectively) in serum. All drug- treated DM2 rats showed significantly lower levels of VEGF, JAK2, P-JAK2, STAT3, and P-STAT3 in retina than DM group, while TWMM and Calcium dobesilate significantly increased SOCS3 in retina. Conclusion: Our data suggest that the diabetic retina protective effect of TWMM might be related to antiinflammatory, antioxidative, upregulation of SOCS3 expression, inhibition of the JAK/STAT/VEGF signaling pathway.

Curcumin has been widely used to treat numerous diseases due to its antioxidant property. The aim of the present study is to investigate the effect of curcumin on skeletal muscle mitochondria in chronic obstructive pulmonary disease (COPD) and its underlying mechanism. The rat model of COPD was established by cigarette smoke exposure combined with intratracheal administration of lipopolysaccharide. Airway inflammation and emphysema were notably ameliorated by the treatment with curcumin. Oral administration of curcumin significantly improved muscle fiber atrophy, myofibril disorganization, interstitial fibrosis and mitochondrial structure damage in the skeletal muscle of COPD rats. Mitochondrial enzyme activities of cytochrome c oxidase, succinate dehydrogenase, Na + /K + -ATPase and Ca 2+ -ATPase in skeletal muscle mitochondria from COPD rats were significantly increased after treatment with curcumin. Moreover, curcumin significantly decreased oxidative stress and inflammation by determining the levels of malondialdehyde, manganese superoxide dismutase, glutathione peroxidase, catalase, IL-6 and TNF-α in skeletal muscle of COPD rats. Furthermore, curcumin significantly increased the mRNA and protein expression of PGC-1α and SIRT3 in the skeletal muscle tissues of COPD rats. These results suggested that curcumin can attenuate skeletal muscle mitochondrial impairment in COPD rats possibly by the up-regulation of PGC-1α/SIRT3 signaling pathway., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Aims: To investigate the effects of curcumin on alveolar epithelial injury in a rat model of chronic obstructive pulmonary disease (COPD) and its potential mechanism., Main Methods: The rat COPD model was established by cigarette smoke exposure combined with intratracheal administration of lipopolysaccharide. Thirty-eight male Sprague-Dawley rats were randomly divided into four groups: control, COPD model, COPD with curcumin and COPD with solvent groups. Neutrophil and macrophage infiltration in bronchoalveolar lavage fluid (BALF) was evaluated, and the levels of IL-6, IL-8 and TNF-α in BALF and serum were determined by ELISA. Histopathological examination and TUNEL staining were used to assess the alveolar epithelial injury. The protein expression of p66Shc and p-p66Shc in the lung tissues was determined by immunohistochemistry and western blot., Key Findings: Curcumin significantly decreased the numbers of total cells, neutrophils and macrophages in BALF from COPD rats. In addition, the levels of IL-6, IL-8 and TNF-α in BALF and serum of COPD rats were significantly decreased after treatment with curcumin. Moreover, curcumin ameliorated emphysema and ultrastructural damage of alveolar epithelial cells in COPD rats. The apoptosis index of alveolar epithelial cells in the COPD with curcumin group was significantly lower than that in the COPD model group. Furthermore, the protein expression of p66Shc and p-p66Shc in alveolar epithelia was significantly decreased in the COPD with curcumin group compared with COPD model group., Significance: Curcumin attenuates alveolar epithelial injury in COPD rats, which may be partially due to the down-regulation of p66Shc., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The study aimed to investigate the metal compositions in indoor PM2.5 and the potential health risks they pose to residents of an urban area in China. A total of 41 and 54 households were surveyed in February and September 2013, respectively. The results showed that the indoor concentrations of metals varied depending on the types of cooking fuels used. All measured concentrations of metals were highest among households using coal for cooking. In the majority of households, non-carcinogenic risks were posed by the use of coal. The carcinogenic risks posed by chromium (VI) and arsenic were generally higher among households using coal for cooking than among those using gas or electricity. The multivariate linear regression model suggested a potential adverse effect from arsenic and cadmium on birth weight and gestational weeks. This study also found that cooking fuel was the most significant factor that contributed to the differences in concentrations of metals in indoor PM2.5 and highlighted the importance of using clean energy for cooking and heating.

Long-term, high dosage protamine zinc insulin (PZI) treatments produce adverse reactions. The trace element selenium (Se) is a candidate for the prevention of diabetes due to anti-oxidative stress activity and the regulation of glycometabolism. In this study, we aimed to investigate the anti-diabetic effects of a combination of PZI and Se on type 2 diabetes. Diabetic KKAy mice were randomized into the following groups: model group and groups that were subcutaneously injected with PZI, Se, high or low dose PZI + Se for 6 weeks. PZI combined with Se decreased the body weight and fasting blood glucose levels. Moreover, this treatment also improved insulin tolerance, as determined by the reduced values from the oral glucose tolerance test and insulin tolerance test, and increased insulin levels and insulin sensitivity index. PZI combined with Se ameliorated skeletal muscle and β-cell damage and the impaired mitochondrial morphology. Oxidative stress was also reduced. Furthermore, PZI combined with Se upregulated phosphatidylinositol 3-kinase (PI3K) and downregulated protein tyrosine phosphatase 1B (PTP1B). Importantly, the low dosage combination produced effects similar to PZI alone. In conclusion, PZI combined with Se improved glycometabolism and ameliorated the tissue and mitochondrial damage, which might be associated with the PI3K and PTP1B pathways.

Bone epithelioid angiosarcoma (EA) is rare and characterized by large, mildly to moderately pleomorphic epithelioid cells, with abundant eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli. The tumors may arise in various locations in bone and the patients may present with unifocal or multifocal osseous disease. We present a unifocal lesion case of EA of the ilium in a 62-year-old woman. A needle biopsy of the ilium was performed and first diagnosed poorly differentiated adenocarcinoma based on CKpan and CK18 immunopositivity. The tumor was treated initially with curettage followed by chemotherapy. The final diagnosis on the surgical specimen was epithelioid angiosarcoma.

Air pollution contributes substantially to global health burdens; however, less is known about pollution patterns in China and whether they differ from those elsewhere. We evaluated temporal and spatial heterogeneity of air pollution in Lanzhou, an urban Chinese city (April 2009-December 2012), and conducted a systematic review of literature on air pollution and health in Lanzhou. Average levels were 141.5, 42.3, and 47.2 µg/m 3 for particulate matter with an aerodynamic diameter ≤10 µm (PM 10 ), NO 2 , and SO 2 , respectively. Findings suggest some seasonality, particularly for SO 2 , with higher concentrations during colder months relative to warmer months, although a longer time frame of data is needed to evaluate seasonality fully. Correlation coefficients generally declined with distance between monitors, while coefficients of divergence increased with distance. However, these trends were not statistically significant. PM 10 levels exceeded Chinese and other health-based standards and guidelines. The review identified 13 studies on outdoor air pollution and health. Although limited, the studies indicate that air pollution is associated with increased risk of health outcomes in Lanzhou. These studies and the high air pollution levels suggest potentially serious health consequences. Findings can provide guidance to future epidemiological studies, monitor placement programs, and air quality policies.

Objective: We screened and identified protease-producing bacterial strains from the Arctic, the results would help find cold-adapted protease., Methods: In total 68 protease-producing strains were screened from the Arctic using the casein-agar plate under low temperature. All strains were classified using the 16S rRNA gene-restriction fragment length polymorphism (RFLP) and traditional phenotypic test. One strain was chosen to be the representative strain from each group respectively and identified using 16S rRNA gene sequence analysis, GenBank database Basic Local Alignment Search Tool (BLAST), phylogenetic analysis and phenotypic features analysis. The enzymatic properties of the representative strains were determined., Results: The 68 strains belonged to 3 groups (54.41%, 42.65% and 2.94%), and strains 6, 11 and 52 were the representative strains respectively. The results of the 16S rRNA gene sequence analysis showed that: Strain 11 was most closely related to Chryseobacterium scophthalmum with 98.24% sequence similarity; strain 52 was most closely related to Stenotrophomonas rhizophila with 98.55% sequence similarity; strain 6 was most closely related to Stenotrophomonas rhizophila with 96.50% sequence similarity, which might represent a novel species of the genus. The phenotypic study showed that: strains 6, 11 and 52 were Gram negative, straight rod-shaped, did not produce extracellular lipase and amylase, possessed strong proteolytic activity. The optimal temperature and pH for the enzyme activity were 55 degrees C and 6.7 for the protease from strain 6, 40 degrees C and 8.5 for the protease from strain 11 and 65 degrees C and 7.4 for the protease from strain 52., Conclusion: The research firstly introduced the distribution of Stenotrophomonas and Chryseobacterium specieses in the Arctic marine water, extended the diversity of the protease-producing bacteria from the Arctic, and provided a useful basis for further study of cold-adapted protease.

Pt supported on mesoporous silica SBA-15 was investigated as a catalyst for low temperature selective catalytic reduction (SCR) of NO by C3H6 in the presence of excess oxygen. The prepared catalysts were characterized by means of XRD, BET surface area, TEM, NO-TPD, NO/C3H6-TPO, NH3-TPD, XPS and 27Al MAS NMR. The effects of Pt loading amount, O2/C3H6 concentration, and incorporation of Al into SBA-15 have been studied. It was found that the removal efficiency increased significantly after Pt loading, but an optimal loading amount was observed. In particular, under an atmosphere of 150 ppm NO, 150 ppm C3H6, and 18 vol.% O2, 0.5% Pt/SBA-15 showed remarkably high catalytic performance giving 80.1% NOx reduction and 87.04% C3H6 conversion simultaneously at 140 degrees C. The enhanced SCR activity of Pt/SBA-15 is associated with its outstanding oxidation activities of NO to NO2 and C3H6 to CO2 in low temperature range. The research results also suggested that higher concentration of O2 and higher concentration of C3H6 favored NO removal. The incorporation of Al into SBA-15 improved catalytic performance, which could be ascribed to the enhancement of catalyst surface acidity caused by tetrahedrally coordinated AlO4. Moreover, the catalysts could be easily reused and possessed good stability.

Objective: To investigate potential pathogens in waters of Xiamen from Jiulong River, and to provide useful information for the prevention and control of potential pathogen infections., Methods: All samples were spread on Thiosulfate Citrate Bile Salts Sucrose (TCBS) agar plates, and then incubated at 26 +/- 1 degrees C for 24 +/- 2 h. In total 158 TCBS strains were isolated from TCBS agar plates and pure-cultivated on 2216E agar plates. All strains were identified using the 16S rRNA gene- Restriction fragment length polymorphism (RFLP), 16S rRNA sequence analysis, GenBank database Basic Local Alignment Search Tool (BLAST) and phylogenetic analysis., Results: The results show that 158 TCBS strains from the sediments of Jiulong River estuary were classfied as 7 genus, which were Pseudomonas (28%), Aeromonas (24%), Pseudoalteromonas (19%), Shewanella (13%), Bacillus (11%), Vibrio (4%) and Psychrobacter (1%). The composition and distribution of TCBS bacteria groups varied with stations. Non-halophilic or haloduric bacteria groups were dominant in the upper area of Jiulong River estuary, and halophilic and haloduric bacteria were dominant in the lower area, which characterized a typical estuary feature. The salinity played a key role in the distribution of TCBS groups. Vibrios did not constitute a significant proportion (6% - 19%) of the total TCBS strains at different stations, and most of the them distributed at the lower region., Conclusion: There were a lot of potential pathogens in Jiulong River estuary. Aeromonas, a typical genus of halotolerant bacteria, was the potentially terrigenous bacteria contamination to the waters of Xiamen. Most Vibrio specieses were marine aborigines, which was not directly contaminated from the runoff of Jiulong River.

Two lactic acid bacteria (LAB) strains, Pediococcus pentosaceus SC1 and Lactobacillus paraplantarum SC2 isolated from king grass silage, were characterized and their effectiveness to improve the silage fermentation quality of stylo (Stylosanthes guianensis Sw.) was studied. Strain SC1 was able to grow at a high temperature of 45°C, while SC2 did not. SC2 normally grew at a low pH of 4.0, while SC1 could not. These two strains and a commercial inoculant of LAB (L. plantarum, LP) were used as additives to stylo silage preparation at various temperatures (20°C, 30°C and 40°C). All LAB inoculants significantly (P < 0.05) reduced the pH value and ammonia-N content, and increased the ratio of lactic acid to acetic acid and quality score compared with the control. In addition, inoculating LAB strains markedly (P < 0.05) reduced butyric acid content at the temperatures of 30°C and 40°C. Compared to SC2 and LP strains, strain SC1 was the most effective for improving stylo silage quality at 20°C, indicated by the increase in lactic acid, ratio of lactic acid to acetic acid and quality score. At 30°C and 40°C, there were no significant differences among SC1, SC2 and LP treatments in pH values, contents of acetic acid, butyric acid and ammonia-N (P > 0.05)., (© 2011 The Authors. Animal Science Journal © 2011 Japanese Society of Animal Science.)